Department of Neurosurgy, Hospital de Clínicas "José de San Martín", School of Medicine, University of Buenos Aires, Buenos Aires, Argentina; Neurosurgery Department, School of Medicine, McMaster University, Hamilton, Canada.
Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut, USA.
World Neurosurg. 2023 Jul;175:e636-e643. doi: 10.1016/j.wneu.2023.03.150. Epub 2023 Apr 7.
To analyze and find risk factors associated with developing transient diabetes insipidus (DI) using a multicenter case series after trans-sphenoidal surgery.
Medical records of patients who underwent trans-sphenoidal surgery for pituitary adenoma resection between 2010 and 2021 at 3 different neurosurgical centers by 4 experienced neurosurgeons were retrospectively analyzed. The patients were divided into 2 groups (DI group or control group). Logistic regression analysis was conducted to identify risk factors associated with postoperative DI. Univariate logistic regression was performed to identify variables of interest. Covariates with a P value <0.05 were incorporated into multivariate logistic regression models to identify independently associated risk factors for DI. All statistical tests were conducted using RStudio.
A total of 344 patients were included; 68% were women, the mean age was 46.5 years, and nonfunctioning adenomas were the most frequent (171, 49.7%). The mean tumor size was 20.3 mm. Covariates associated with postoperative DI were age, female gender, and gross total resection. The multivariable model showed that age (odds ratio [OR] 0.97, CI 0.95-0.99, P = 0.017) and female gender (OR 2.92, CI 1.50-6.03, P = 0.002) remained significant predictors of DI development. Gross total resection was no longer a significant predictor of DI in the multivariable model (OR 1.86, CI 0.99-3.71, P = 0.063), suggesting that this variable may be confounded by other factors.
The independent risk factors for the development of transient DI were female and young patients.
通过多中心病例系列分析，研究经蝶窦手术后发生短暂性尿崩症（DI）的相关危险因素。
回顾性分析 2010 年至 2021 年间由 4 名经验丰富的神经外科医生在 3 个不同的神经外科中心进行的经蝶窦垂体腺瘤切除术的患者的病历。患者被分为 2 组（DI 组或对照组）。采用 logistic 回归分析确定与术后 DI 相关的危险因素。采用单因素 logistic 回归分析确定感兴趣的变量。将 P 值<0.05 的协变量纳入多因素 logistic 回归模型，以确定 DI 的独立相关危险因素。所有统计检验均使用 RStudio 进行。
共纳入 344 例患者；68%为女性，平均年龄为 46.5 岁，最常见的是无功能腺瘤（171 例，49.7%）。肿瘤平均大小为 20.3mm。与术后 DI 相关的协变量为年龄、女性性别和大体全切除。多变量模型显示，年龄（比值比[OR]0.97，95%CI 0.95-0.99，P=0.017）和女性性别（OR 2.92，95%CI 1.50-6.03，P=0.002）仍然是 DI 发生的显著预测因素。大体全切除在多变量模型中不再是 DI 的显著预测因素（OR 1.86，95%CI 0.99-3.71，P=0.063），这表明该变量可能受到其他因素的干扰。
发生短暂性 DI 的独立危险因素为女性和年轻患者。
